title: Surgical treatment for constipation in children and adults.
abstract: Functional constipation is one of the most common gastrointestinal disorders. In both children and adults, most patients are managed conservatively with good results. In this review, we focus on the surgical approach to constipation. Patients who lack the capacity to consistently have voluntary bowel movements may need mechanical emptying of the colon through an enema program; for them, surgery to allow for antegrade enemas, (via the appendix or using a button device) is useful. Those patients with severe constipation not responsive to intense medical treatment may be candidates for other surgical interventions, such as resection of the dysfunctional colonic segment (rectosigmoid or whole colon), or plication, -pexy, and STARR techniques for evacuatory disorders secondary to obstructive anatomical features. Permanent stomas are an option of last resort.
authors.affiliation: Department of Surgery, University of Cincinnati, Colorectal Center for Children, Cincinnati Children's Hospital, 3333 Burnet Avenue, ML 2023, Cincinnati, OH 45229, USA. Marc.levitt@cchmc.org
authors.forename: Marc A
authors.initials: MA
authors.lastname: Levitt
authors.forename: Kellie L
authors.initials: KL
authors.lastname: Mathis
authors.forename: John H
authors.initials: JH
authors.lastname: Pemberton
mesh_terms: D000328:Adult; D002648:Child; D003106:Colon / Q000503:physiopathology / Q000601:surgery*; D003248:Constipation / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D003672:Defecation; D013505:Digestive System Surgical Procedures / Q000009:adverse effects; D006801:Humans; D018579:Patient Selection; D012720:Severity of Illness Index; D016896:Treatment Outcome